What are opioids?
Opioids are psychoactive chemicals that
can come from three sources: naturally from the resin of the poppy plant (morphine and codeine); synthetically from a lab (fentanyl and methadone); and derived from natural opiates to create semi-synthetic opioids in the lab (oxycodone, heroin and hydromorphone). They all work by binding to opioid receptors in the central and peripheral nervous system and the gastrointestinal tract. Prescription opioids are intended as pain reducers, but most can also create feelings of euphoria. Their strength ranges from codeine to illegal carfentanil.
CODEINE
Is the world’s most common opioid. It is used in cough syrups and combined with acetaminophen to make Tylenol 3. It’s one-tenth as potent as morphine but still potentially addictive and dangerous.
METHADONE
Though it’s used to treat opioid addiction and doesn’t provide people with a euphoric feeling, it’s an opioid that is one-half as powerful as morphine. Patients are usually required to take it on-site at methadone clinics and are subjected to regular urine screening to ensure they aren’t taking other drugs that could combine with methadone and result in an overdose. It’s an odourless, colourless liquid with a bitter taste, so it’s usually mixed with orange juice.
MORPHINE
Can be taken orally or by injection, which makes it four times as powerful. In 2015, it was involved in more deaths in Windsor and Essex County than any other opioid.
OXYCODONE
Is up to twice as powerful as morphine. Oxycodone’s most popular commercial version was OxyContin, a pill with varying strengths that was involved in 31 local deaths in 2011 before the formulation was changed to OxyNeo to prevent tampering that negated its time-release properties. It is also in Percocet along with acetaminophen.
HEROIN
Is an illicit injected street drug that’s four times more powerful than morphine. Use of heroin has exploded in the United States in response to doctors cutting back on opioid prescribing. It isn’t very prevalent in Windsor and Essex County, where there were only two heroin-related deaths between 2010 and 2015.
HYDROMORPHONE
Its commercial name is Dilaudid, and it’s five times more powerful than morphine.
FENTANYL
Is most commonly used in time-release patches affixed to the skin. Addicts were known to buy used patches that still had residual fentanyl. In the last year, efforts to cut down on illicit use of patches by requiring that patients trade in their old patches to get new ones has been relatively successful. Fentanyl is 50-100 times more powerful than morphine. Illegally made fentanyl in powdered form has caused a rash of overdose deaths in the U.S. and Western Canada.
CARFENTANIL
Used as an elephant tranquillizer, this synthetic opioid is at least 10,000 times more powerful than morphine.